OBJECTIVE: A multi-center, open-labeled, prospective, observational study was conducted to evaluate the efficacy of fluoxetine on energy level over 8 weeks in a group of Korean patients with major depressive disorder. METHODS: Of 635 (Ed- to avoid having to say "Six hundred..") patients with major depressive disorder in 24 centers who were recruited to 8 weeks treatment with fluoxetine, 136 were terminated at initial session, leaving 499 patients to be included in the final analysis. They were predominantly female (59.5%), with a mean age of 45.7+/-15.9 years. At three visits to the clinic (weeks 0, 4 and 8), a record was made of Retardation Factor score of Hamilton Rating Scale for Depression (HD-RF), Lack of Energy score of Symptom Check List-90R (SCL-E), Energy score (QOL-E) and Fatigue score (QOL-F) of Quality of Life, and Visual Analogue Scale for Energy Level (VAS-E). RESULTS: The average dose of fluoxetine was 18.5+/-6.8mg/day for the first 4 weeks and 25.3+/-10.6 mg/day for the second 4 weeks. Of the patients, 85.4% in the first 4-week period and 86.8% in the second 4-week period took more than 85% of the prescribed medication. At least one of the concomitant anxiolytic drugs with fluoxetine was prescribed to 79.8% of the patients (alprazolam 47.9%, lorazepam 21.4%). The energy symptoms were significantly improved by fluoxetine over time, according to the analysis controlling the improvement effect of global depressive symptoms using repeated measures ANCOVA with the change of total HAM-D score as a covariate. Even comparing with the patients who took concomitant anti-anxiety medication, those who did not take concomitant anti-anxiety medication showed greater improvement of energy symptoms irrespective of the severity of baseline anxiety symptoms. CONCLUSION: These findings demonstrate that fluoxetine is effective in restoring the energy of patients with major depressive disorder. They also suggest that physicians should be careful in prescribing sedating antidepressants or concomitant anti-anxiety medication with fluoxetine for patients with major depressive disorder.
Antidepressive Agents ; Anxiety ; Depression ; Depressive Disorder, Major* ; Fatigue ; Female ; Fluoxetine* ; Humans ; Lorazepam ; Observational Study* ; Prospective Studies ; Quality of Life

OBJECTIVES: The objective of this study was to identify the association of food intake with bio-physiological indicators: blood pressure, body mass index (BMI), waist/hip ratio (WHR), cholesterol and urine sugar among rural people. METHODS: The subjects were 890 inhabitants from 14 towns of G County in Honam province. Data were collected by interview and self-reported with structured questionnaires from April 6th to 30th 2005. Data were analyzed with the frequency, percentage, t-test, chi-square-test, ANOVA, Scheffe test and ANCOVA using SPSS 12.0 program. RESULTS: Pre-hypertensive and hypertensive group was 27.0%, overweight and obese 27.1%, more than 0.90 in WHR 42.0%, more than 201 mg/dl of cholesterol 23.9%, and positive urine sugar was 8.7% in general. Among eleven food groups, fruit intakes were more effective in normotensive group than in the others. Vegetables, liquors, and milk products were 0.90 WHR more effective than the others. Milk products and liquors in BMI, and grains, beans and seaweed in low cholesterol group were more effective than the others. CONCLUSIONS: Bio-physiological indicators are related significantly only with fruits, milk products, meats, cereal and liquors among eleven food categories. Further study on the relationship between food intake, physical activities, smoking, drinking and lifestyle with bio-physiological indicators are suggested.
Adult ; Blood Pressure ; Body Mass Index ; Cholesterol ; Drinking ; Edible Grain ; Eating ; Fabaceae ; Fruit ; Humans ; Hypertension ; Life Style ; Meat Products ; Milk ; Motor Activity ; Overweight ; Seaweed ; Smoke ; Smoking ; Vegetables ; Surveys and Questionnaires

No abstract available.
Congenital Abnormalities*

PURPOSE : Developmental screening tests are in widespread use, but few reliable and valid tests are available. One of the oldest and best known developmental screening test was recently restandardized and revised as Denver II. Because the Denver II was published without evidence of its accuracy in developmental screening, we evaluate its accuracy in chidren with developmental delay to see whether it can be used on Korean children. METHODS : The Denver II was translated and was administered to 244 children attending the child development clinic in Kangnam St. Mary's Hospital to evaluated motor delay(Group I, n=68), language delay(Group II, n=84) or other problem(Group III, n=92). RESULTS : 1) The ratio of male to female and the mean age of the subject were 2.4:1 and 25.1 months overall, 1.6:1 and 11.8 months in Group I, 4.6:1 and 35.6 months in Group II, and 1.3:1 and 25.4 months in Group III. 2) The distribution of results(abnormal, normal and questionable) were 76%, 13% and 10% in Group I, 76%, 10% and 14% in Group II, and 38%, 53% and 9% in Group III. 3) The neurologic problems were determined 75%(cerebral palsy, central hypotonia, infantile spasm, myopathy etc.) in Group I, 74%(mental retardation, developmental language disorder, epilepsy, cerebral palsy etc.) Group II and 39%(mental retardation, epilepsy, cerebral palsy etc.) in Group III. 4) The sensitivity and the specificity of Denver II were 0.88 and 0.41 in Group 1, 0.90 and 0.27 in Group II, 0.81 and 0.77 in Group III, and 0.85 and 0.59 overall. CONCLUSION: Although the Denver II in identifying children at risk for developmental delay has a excellent sensitivity, it has a poor specificity, especially in identifying children at risk for language delay. These results demonstrate that the Denver fail to reliably identify children in need of developmental delay evaluation. So the Denver II should be standardized and modified to be used on Korean children with developmental delay.
Cerebral Palsy ; Child ; Child Development ; Epilepsy ; Female ; Humans ; Infant ; Infant, Newborn ; Language Development Disorders ; Male ; Mass Screening* ; Muscle Hypotonia ; Muscular Diseases ; Paralysis ; Sensitivity and Specificity ; Spasms, Infantile

No abstract available.
Pulmonary Artery*

We experienced a case of late infantile Batten's disease in a 4-year-7-month-old boy who was admitted to child neurology service of Kangnam St. Mary's hospital for evaluation of progressive psychomotor deterioration. He was in quite normal state of development until 3 years of age when his mother first became concerned because he showed such emotional change as crying and fear, Since then he acted strange and major motor milestones were progressively deteriorated, and eventually he was unable to walk and run at 4 years of age. At that time the patient began to have seizure and it was described as jerking movements of both arms simultaneously and generalized tonic clonic movements of upper and lower extremities. Denver developmental examination revealed a severe retardation in all his developmental milestones. On admission he has definitely mentally retarded, he had no speech and his vision was impaired. He had noted bilateral nystagmus. Fundi revealed pale sharp disc, dark degeneration of macula and marked attenuated retinal arterioles. Brain CT showed mild cortical atrophy. EEG showed paroxysmal burst spikes and slow waves which was compatible with myoclonic seizures. AEP and needle EMG studies were normal. A diagnosis of Batten's disease was made on the basis of brain biopsy which showed ballooning of the large neurons, granular lipopigment bodies in cytoplasm, bright fluorescence cytoplasmic granules under UV light and numerous dense bodies on EM finding. He died at the age of 12 years due to pneumonia.
Arm ; Arterioles ; Atrophy ; Biopsy ; Brain ; Child ; Crying ; Cytoplasm ; Cytoplasmic Granules ; Diagnosis ; Electroencephalography ; Fluorescence ; Humans ; Lower Extremity ; Male ; Mentally Disabled Persons ; Mothers ; Needles ; Neurology ; Neurons ; Pneumonia ; Retinaldehyde ; Seizures ; Ultraviolet Rays

Down syndrome is perhaps the most common genetic condition associated with mental retardation. In cytogenetic examination, trisomy 21 is in 95% of Down syndrome, and the others are mosaicism, translocation or deletion. There are many associated diseases with Down syndrome such as, thyroid function abnormality, congenital heart disease, intestinal blockage, and so on. Hypothyroidism appeared in 15% before adolescent in Down syndrome patients. In Korea, there were several reports of Down syndrome with hypothyroidism in childhood but not in adulthood. And we had three cases of hypothyroidism with Down syndrome in adulthood. Cytogenetic examination revealed trisomy 21 in the 2 cases and 1 case of mosaicism. Antithyroid antibody was positive in one case. None of these cases was admitted due to symptoms of hypothyroidism. It is very difficult to make the diagnosis of hypothyroidism in Down syndrome because of similarity in symptoms between Down syndrome and hypothyroidism. Thus, periodic thyroid function test should be made in Down syndrome, and this could be a part of improving quality of life in Down syndrome.
Adolescent ; Adult* ; Congenital Abnormalities ; Cytogenetics ; Diagnosis ; Down Syndrome* ; Heart Diseases ; Humans ; Hypothyroidism* ; Intellectual Disability ; Korea ; Mosaicism ; Quality of Life ; Thyroid Function Tests ; Thyroid Gland

PURPOSE: Excitotoxic injury of the dendrites of inhibitory interneurons could lead to decrease in their synaptic activation, and explain subsequent local circuit hyperexcitability and epilepsy. A hallmark of dendrotoxicity at least in principal neurons of the hippocampus and cortex are focal or varicose swellings of dendritic abors. This research was designed to study morphologic changes of interneuron dendrite in kainate-treated hippocampal slice culture overtime. METHODS: Cultures aged 15-16 Equivalent Postnatal Days (EPD) were exposed to 10 microM kainic acid (KA), and analyzed at 0, 8, 24, 48, 72 hours after transient (1 hour) KA exposure. Neuronal injury was determined by morphologic changes of interneuron dendrites in area CA1 of DiI stained sections. RESULTS: 1) Transient (1 hour) exposure of hippocampal explant cultures to KA produced marked focal swellings of the dendrites of DiI stained interneurons in a highly reproducible manner. 2) The presence of focal swellings was reversible with kainate washout. The dendrites of KA treated explants were no longer beaded at 8, 24, 48, 72 hours after KA exposure. 3) There was no significant difference in the thickness of dendrites in DiI stained interneuron among 8hr, 24hr, 48hr and 72hr recovery group, compared with control group. CONCLUSION: The presence of focal swellings was reversible with kainate washout, and was not accompanied by interneuronal cell death.
Cell Death ; Dendrites* ; Epilepsy ; Hippocampus ; Interneurons* ; Kainic Acid ; Neurons

Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
Agranulocytosis ; Antithyroid Agents ; Depressive Disorder ; Drug Therapy ; Goiter* ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Lithium Carbonate* ; Lithium* ; Mass Screening ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis ; Thyroxine

PURPOSE: Excitotoxic injury of the dendrites of inhibitory interneurons could lead to decrease in their synaptic activation, and explain subsequent local circuit hyperexcitability and epilepsy. A hallmark of dendrotoxicity at least in principal neurons of the hippocampus and cortex are focal or varicose swellings of dendritic abors. This research was designed to study morphologic changes of interneuron dendrite in kainate-treated hippocampal slice culture overtime. METHODS: Cultures aged to 15-16 Equivalent Postnatal Day (EPD) were exposed to 10microM kainic acid (KA), and were analyzed at 0, 8, 24, 48, 72 hours after transient (1 hour) KA exposure. Neuronal injury was determined by morphologic changes of parvalbumin (PV) positive interneuron dendrites in area CA1 of PV-immunohistochemically stained sections. RESULTS: 1) Transient (1 hour) exposure of hippocampal explant cultures to KA produced marked focal swellings of the dendrites of PV-immunoreactive interneurons in a highly reproducible manner. 2) The presence of focal swellings was reversible with kainate washout. The dendrites of KA treated explants were no longer beaded at 8, 24, 48, 72hours after KA exposure.3) The number of cells in PV-immunoreactive interneuron was decreased at 0, 8, 24 hours after exposure. But there was no significant difference among 48hr and 72hr recovery group compare with control group.4) The total length of dendrites was decreased between 0 and 8hours after exposure. But there was no significant difference among 24, 48, and 72hr recovery group compare with control group.5) The branches of dendrites were decreased just after exposure. But there was no significant difference among 8hr, 24hr, 48hr, and 72hr recovery group compare with control group. CONCLUSION: The presence of focal swellings was reversible with kainate washout, and was not accompanied by interneuronal cell death.
Cell Death ; Dendrites* ; Epilepsy ; Hippocampus ; Interneurons* ; Kainic Acid ; Neurons